ALERT: CMS extends HIPAA version 5010 Electronic Billing Transactions deadline

By Raymond Janevicius, MD

11/30/2011 at 11:00AM

The Jan. 1 compliance deadline for HIPAA 5010 remains unchanged, but CMS has delayed until March 31 its rule requiring providers to switch to using the HIPAA 5010 standards for the electronic transactions.

Physicians should, however, convert to HIPAA 5010 as soon as possible. Beginning April 1, electronic claims will be rejected if they are not submitted using HIPAA 5010 standards.

All entities involved in your electronic claims submissions must use Version 5010 as of April 1.

HIPAA 5010 is a new set of standards regulating electronic transactions, including claims, eligibility, referrals and remittances.

Implementation of HIPAA 5010 is critical, as it accommodates the new ICD-10 coding structure, as well as other important electronic transactions required for insurance eligibility confirmation and claims payment.

One new requirement of HIPAA 5010 is that all electronic and paper claims must use actual physical addresses. P.O. Box numbers will no longer be acceptable.

Another new requirement is use of a nine-digit ZIP code on all electronic and paper claims for providers and facilities.

For more information, please download the AMA HIPAA 5010 Toolkit – the Physician's Practical Guide to Implementing HIPAA version 5010.

Do not delay! You must begin planning and implementation now to meet compliance deadlines.